Tx: minimize all overhead activity. Immobilization not recommended. NSAIDs as always. Cryotherapy (ice) 3-4x/day. Exercises: pendulum swings in clockwise/counterclockwise to level of pain. Also walk fingers up wall. Steroid injections can be effective though can cause muscular atrophy/weakness.

Rotator Cuff Tears: acute injury rare (10%); majority related to chronic injury/use. Glenohumeral dislocation is common cause of tear. If dislocation with age> 40, 60% have tear. If still having weakness > 3 weeks after injury, likely tear involved. Partial thickness 2x more common than full tear – conservative treatment where as full tear usually requires surgery. Supraspinatus most common tendon injured.

Calcific Tendonitis: calcium deposits within the tendon. Females > males, age 40-60. Supraspinatus most likely involved. Calcium near proximal humerus. Catchy sensation on movement. Sometimes warm/tender shoulder. During resorptive phase, increase in pain can occur. Usually self-limited, lasting 1-2 weeks. Adhesive capsulitis most common complication. Worse at night, resorptive usually spontaneous. Tx: Same as above, keep arm abducted slightly either on back of chair or pillow in armpit at night. Can get ‘needle lavage’ to break up tension within tendon.